Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 1/28/2019 Final Date: 2/26/2019
Effective Date: 4/1/2019 Withdrawal Date:
Rule: Title 23: Division of Medicaid; Part 200: General Provider Information; Chapter 4: Provider Enrollment; Rule 4.10: 340B Providers
Summary: This filing is to include language which was omitted with the final filing of system number 23710.
System Number: 23963Notice | Full Text

2018

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 12/6/2018 Final Date: 1/11/2019
Effective Date: 3/1/2019 Withdrawal Date:
Rule: Title 23: Division of Medicaid, Part 203: Physician Services, Chapter 4: Surgery, Rule: 4.18 Reduction Mammoplasty
Summary: This Administrative Code is being filed to add primary care physician documentation requirements for reduction mammoplasty and remove that the final determination of medical necessity is made by the surgeon, effective March 1, 2019.
System Number: 23868Notice | Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 12/6/2018 Final Date: 1/11/2019
Effective Date: 3/1/2019 Withdrawal Date:
Rule: Title 23: Medicaid, Part 202: Hospital Services, Chapter 1: Inpatient Services, Rule 1.1: Definitions, 1.14: Inpatient Hospital Payments, 1.16: Split Billing
Summary: This Administrative Code is being filed to add clarifying language to the three (3) day payment window rule to instruct providers to split bill for the outpatient services provided outside of the three (3) day window on a claim separate from the inpatient claim, if outpatient services are provided more than three (3) days prior to admission to a beneficiary by the admitting hospital, or an entity wholly owned or operated by the admitting hospital, and the outpatient service dates span to days outside of the three (3) day window the hospital must, effective March 1, 2019.
System Number: 23867Notice | Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 10/5/2018 Final Date: 10/31/2018
Effective Date: 12/01/2018 Withdrawal Date:
Rule: Part 223: Early and Periodic Screening, Diagnosis and Treatment (EPSDT), Chapter 1: General, Rule 1.1: Program Description; Rule 1.5: Early and Periodic Screening, Diagnosis and Treatment (EPSDT) Screenings; Rule 1.6: Documentation Requirements for Early and Periodic Screening, Diagnosis and Treatment (EPSDT) Screenings; Rule 1.8: Reimbursement; Diagnosis and Treatment (EPSDT) Screenings
Summary: This administrative code is being filed to correspond with State Plan Amendment (SPA) 18-0014 EPSDT which revises language to reflect the recommendations in the fourth (4th) edition of the American Academy of Pediatrics (AAP) Bright Futures Periodicity Schedule published in February of 2017. This final filing removes New Rules 1.9 AND 1.10, effective December 1, 2018.
System Number: 23755Notice | Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 6/29/2018 Final Date: 8/9/2018
Effective Date: 9/9/2018 Withdrawal Date:
Rule: Title 23: Medicaid, Part 201: Transportation, Chapter 1: Emergency Transportation, Rule 1.7: Ambulance Transport of Nursing Facility Residents by Ambulance; Chapter 2: Non-Emergency Transportation (NET)Broker Program, Rule 2.4: Transport of Nursing Facility Residents by NET.
Summary: This final filing delays implementation of the removal of long-term care (LTC) residents from the Non-Emergency Transportation (NET) Broker program until February 1, 2019. However, the removal of language allowing NET ambulance services provided to LTC residents to be billed directly to the Division of Medicaid will still be effective September 1, 2018. LTC facilities must utilize the NET broker to provide NET services to residents or place the cost of providing NET services on the cost report. Effective February 1, 2019, LTC facilities cannot use the NET Broker to arrange transportation for residents and must place all NET costs on the cost report. This filing corresponds with the changes to Title 23, Part 207, Chapters 2, 3, and 4.
System Number: 23575Notice | Full Text | Comments

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 6/22/2018 Final Date: 7/19/2018
Effective Date: 9/1/2018 Withdrawal Date:
Rule: Title 23, Part 215, Rules 1.1-1.10
Summary: The MS Division of Medicaid’s Administrative Code proposed
filing is to amend Title 23: Medicaid, Part 215: Home Health. This
Administrative Code filing is being submitted to require (1) a face-to-face visit
with a physician or authorized non-physician practitioner prior to the initiation
of home health visits or provision of durable medical equipment (DME) and
appliances, (2) to require the provision of home health services in any setting
in which normal life activities take place, and (3) to revise the definition of
DME to comply with the Medicaid Home Health Final Rule, published
February 2, 2016.
System Number: 23528Notice | Full Notice

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 6/22/2018 Final Date: 7/19/2018
Effective Date: 9/1/2018 Withdrawal Date:
Rule: Title 23, Part 209, Chapter 1, Rules 1.3, 1.4,1.6, 1.9, 1.10,1.12-1.21, 1.23-1.33, 1.35-1.45, 1.47, 1.48, 1.51, 1.52, Chapter 2, Rules 2.1, 2.2 and 2.5
Summary: This Administrative Code filing is being submitted to require (1) a face-to-face visit with a physician or authorized non-physician practitioner prior to the initiation of home health visits or provision of durable medical equipment (DME) and appliances, (2) to require the provision of home health services in any setting in which normal life activities take place, (3) to revise the definition of DME to comply with the Medicaid Home Health Final Rule, published February 2, 2016, and (4) to remove language allowing physician assistants and nurse practitioners to order DME. This Administrative Code filing is being submitted to comply with 42 C.F.R. Part 440 effective September 1, 2018.
System Number: 23533Notice | Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 5/24/2018 Final Date: 6/20/2018
Effective Date: 8/1/2018 Withdrawal Date:
Rule: Title 23: Medicaid, Part 207: Institutional Long-Term Care, Chapter 2: Nursing Facility, Rule 2.6: Per Diem.
Summary: This Administrative Code is being submitted to include respiratory therapy services in the list of items and services included in the Division of Medicaid’s per diem rates, to correspond with SPA 18-0001 and be in compliance with 42 C.F.R. § 483.65.
System Number: 23445Notice | Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 5/21/2018 Final Date: 6/18/2018
Effective Date: 8/1/2018 Withdrawal Date:
Rule: Title 23: Medicaid, Part 200: General Provider Information, Chapter 1: General Administrative Rules for Providers, Rule 1.3: Maintenance of Records.
Summary: This Administrative Code adds language which prohibits providers from billing the Division of Medicaid for providing or accessing records substantiating services provided and claims submitted as is required by the Provider Agreement. It also revises the retention of records providers who are required to submit cost reports from five (5) years to three (3) years in compliance with Senate Bill 2836 effective July 1, 2018.
System Number: 23441Notice | Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 5/22/2018 Final Date: 6/18/2018
Effective Date: 8/1/2018 Withdrawal Date:
Rule: Title 23: Medicaid, Part 209: Durable Medical Equipment and Medical Supplies, Chapter 1: Durable Medical Equipment, Rule 1.11: Augmentative Communication Device (ACD)
Summary: This administrative code filing is being filed to revise the requirement of the evaluation and recommendation for an Augmentative Communication Device (ACD) must be completed by a speech-language pathologist (SLP) in conjunction with other health care professionals as appropriate.
System Number: 23440Notice | Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 10/4/2017 Final Date: 10/31/2017
Effective Date: 12/01/2017 Withdrawal Date:
Rule: Title 23: Medicaid, Part 208: Home and Community-Based Services (HCBS) Long-Term Care, Chapter 5: Home and Community-Based Services (HCBS) Intellectual Disabilities/Developmental Disabilities (ID/DD)Waiver, Rule 5.5: Covered Services and Rule 5.7: Reimbursement. Summary: This administrative code filing is to require ID/DD providers to use the Division of Medicaid’s Electronic Visit Verification (EVV) system, MediKey, for payment of In-Home Respite and Home and Community Supports and to ensure that persons receive these services according to the person’s approved plan of services and supports (PSS).
System Number: 23013Notice | Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 8/30/2017 Final Date: 9/25/2017
Effective Date: 11/01/2017 Withdrawal Date:
Rule: Title 23: Medicaid, Part 222: Maternity Services, Chapter 1: General, New Rule 1.11: Screening, Brief Intervention, and Referral to Treatment (SBIRT) Services.
Summary: This administrative code is being submitted to correspond with SPA 17-0003 SBIRT which allows the Division of Medicaid to provide early intervention services for pregnant women with nondependent substance use and to prevent problematic substance use disorders as requested by ReNew Mississippi.
System Number: 22958Notice | Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 5/24/2017 Final Date: 6/26/2017
Effective Date: 8/1/2017 Withdrawal Date:
Rule: Title 23, Part 207, Chapter 3, Rules 3.1-3.11
Summary: This Administrative Code filing is being submitted to remove outpatient treatment that occurs two (2) or more days per week, including dialysis, chemotherapy or treatment for a catastrophic illness, from the home/therapeutic leave day limit in an intermediate care facility for individuals with intellectual disabilities (ICF/IID). This filing also includes a new rule for provider enrollment requirements for ICF/IIDs and changes all references to mentally retarded (MR) to individuals with intellectual disabilities (IID).
System Number: 22824Notice | Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 10/25/2016 Final Date: 11/22/2016
Effective Date: 1/1/2017 Withdrawal Date:
Rule: Part 103: Resources, Chapter 1: Introduction to Resources, Rule 1.10: Liberalized Resource Policy Overview; Chapter 2: Ownership Interest, Rule 2.9: Verifying Current Market Value (CMV); Chapter 5: Trust Provisions, Rule 5.17: Income Trusts; Chapter 6: Annuities, Rule 6.4: Treatment of Annuities Purchased on or after 2/8/2006. Summary: This Administrative Code filing is being submitted to clarify that annuities purchased by an institutionalized individual or his/her spouse during the 5-year look-back period must name the Division of Medicaid as a remainder beneficiary. It also inserts missing language regarding payment due to the Division of Medicaid in the month of entry into a nursing facility for someone under an Income Trust.
System Number: 22408Notice | Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 9/1/2016 Final Date: 9/28/2016
Effective Date: 11/1/2016 Withdrawal Date:
Rule: Title 23: Division of Medicaid, Part 305: Program Integrity, Chapter 1: Program Integrity, Rules 1.1: Fraud and Abuse, New Rule 1.2: Fraud, Waste and Abuse, New Rule 1.3: Overpayments, New Rule 1.4: Corrective Action Plan (CAP), New Rule 1.5: Improper Payments Due to Inaccurate Eligibility Information, New Rule 1.6: Medicaid Eligibility Quality Control.
Summary: This Administrative Code filing is being submitted to clarify that interest may be charged by the Division of Medicaid for improper payments and to move duplicative information in Part 100 to Part 305.
System Number: 22290Notice | Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 9/1/2016 Final Date: 9/27/2016
Effective Date: 11/1/2016 Withdrawal Date:
Rule: Title 23: Medicaid, Part 207: Institutional Long-Term Care, Chapter 2: Nursing Facility, Rule 2.6: Per Diem; Chapter 3: Intermediate Care Facility for Individuals with Intellectual Disabilities (ICF/IID), Rule 3.4: Per Diem.
Summary: This Administrative Code filing is being submitted to clarify that oxygen tanks and its contents are included in the per diem. Additionally, this filing removes the term Private from Nursing Facility for the Severely Disabled (NFSD) to correspond with SPA 15-004.
System Number: 22289Notice | Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 7/13/2016 Final Date: 8/8/2016
Effective Date: 10/1/2016 Withdrawal Date:
Rule: Title 23: Division of Medicaid, Part 300: Appeals, Chapter 1: Appeals, Rule 1.1: Administrative Hearings for Providers.
Summary: This administrative code filing revises language making the time period for a provider to file a court level appeal of a Division of Medicaid final decision from thirty (30) days to sixty (60) days.
System Number: 22155Notice | Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 5/26/2016 Final Date: 6/21/2016
Effective Date: 8/1/2016 Withdrawal Date:
Rule: Title 23: Medicaid, Part 214: Pharmacy Services, Chapter 1: General Pharmacy, Rule 1.7: Refills/Renewals of Prescription Drugs
Summary: This filing provides language to allow pharmacy providers to make prescription refill reminders when the pharmacy provider: 1) Obtains written authorization from the beneficiary or the beneficiary’s responsible party to receive prescription refill reminders, 2) Informs the beneficiary or the beneficiary’s responsible party of their freedom of choice of pharmacy providers with each prescription refill reminder, and 3) Offers the beneficiary or the beneficiary’s responsible party the opportunity to choose whether or not to proceed with each prescription refill.
System Number: 22038Notice | Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 2/1/2016 Final Date: 2/29/2016
Effective Date: 4/1/2016 Withdrawal Date:
Rule: Title 23: Medicaid, Part 208: Home and Community Based Long-Term Care, Chapter 6: Bridge to Independence (B2I), Rule 6.2: Eligibility. Summary: This administrative code filing adds language requiring that a transitioning person’s residence must pass a U.S. Department of Housing and Urban Development Housing Quality Standards inspection to participate in the Bridge to Independence (B2I) demonstration project.
System Number: 21805Notice | Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 1/5/2016 Final Date: 2/4/2016
Effective Date: 4/1/2016 Withdrawal Date:
Rule: Part 207: Institutional Long-Term Care, Chapter 3: Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF/IID), Rule 3.4: Per Diem. Summary: This filing includes language requiring Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF/IIDs) to notify the resident and the resident’s guardian or legal representative of a transfer or discharge in an easily understood written notice. This filing also requires ICF/IIDs to maintain documentation of a transfer or discharge including reasons for the transfer or discharge, and to provide sufficient preparation and orientation to beneficiaries prior to a transfer or discharge. Added “the Division of Medicaid, or a designated entity” to rule 3.4.D.8., added “calendar” to rule 3.4.F.4.a) and rule 3.4.F.4.a)4), and removed the clause “if the resident is being transferred or discharged due to changes in the residents health” from rule 3.4.F.5.
System Number: 21755Notice | Full Text

2015

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 11/5/2015 Final Date: 12/1/2015
Effective Date: 1/1/2016 Withdrawal Date:
Rule: Title 23: Medicaid, Part 213: Therapy Services, Chapter 1: Physical Therapy, Rules 1.3: Covered Services, 1.4: Non-Covered Services, 1.5: Assistants, Aides and Students; Chapter 2: Occupational Therapy, Rules 2.3: Covered Services, 2.4: Non-Covered Services; Chapter 3: Outpatient Speech-Language Pathology (Speech Therapy), Rules 3.3: Covered Services, 3.4: Non-covered Services Summary: This filing is to allow (1) a state licensed therapist to supervise up to four (4) assistants at a time during a work day, (2) reimbursement for assistants to provide services in settings other than an outpatient hospital, and (3) reimbursement for student-assisted physical therapy, occupational therapy, speech-language pathology or audiology services as long as the state licensed therapist is supervising no more than one (1) student at a time during a work day.
System Number: 21674Notice | Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 10/27/2015 Final Date: 11/24/2015
Effective Date: 1/1/2016 Withdrawal Date:
Rule: Title 23: Division of Medicaid, Part 224: Immunizations, Chapter 1: General, Rule 1.1: New Vaccines, Rule 1.2: Tuberculin Skin Test, Rule 1.3: Vaccines for Children, Rule 1.4: Vaccines for Adults, Rule 1.5: Nursing Facility Residents, Rule 1.7: Vaccines Available Through the Pharmacy Venue. Summary: This filing is to include coverage language for the Measles, Mumps, and Rubella (MMR) and Varicella vaccines according to the indications and guidelines of the Centers for Disease Control and Prevention (CDC) for beneficiaries nineteen (19) and older. Non-substantive changes made to Rule 1.5 by replacing “Reserved Moved to Miss. Admin. Code” with “Refer to”, added a description to the CDC acronym in Rule 1.7 and replaced the word “significantly” with the word “separately” in Rules 1.3 and 1.4.
System Number: 21669Notice | Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 10/27/2015 Final Date: 11/24/2015
Effective Date: 1/1/2016 Withdrawal Date:
Rule: Title 23: Division of Medicaid, Part 224: Immunizations, Chapter 1: General, Rule 1.1: New Vaccines, Rule 1.2: Tuberculin Skin Test, Rule 1.3: Vaccines for Children, Rule 1.4: Vaccines for Adults, Rule 1.5: Nursing Facility Residents, Rule 1.7: Vaccines Available Through the Pharmacy Venue. Summary: This filing is to include coverage language for the Measles, Mumps, and Rubella (MMR) and Varicella vaccines according to the indications and guidelines of the Centers for Disease Control and Prevention (CDC) for beneficiaries nineteen (19) and older. Non-substantive changes made to Rule 1.5 by replacing “Reserved Moved to Miss. Admin. Code” with “Refer to”, added a description to the CDC acronym in Rule 1.7 and replaced the word “significantly” with the word “separately” in Rules 1.3 and 1.4.
System Number: 21669Notice | Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 9/29/2015 Final Date: 10/26/2015
Effective Date: 12/1/2015 Withdrawal Date:
Rule: Title 23: Division of Medicaid, Part 218: Hearing Services, Chapter 1: General, Rule 1.3: Bone Anchored Hearing Aid Summary: This filing is to include language for coverage of a non-implantable auditory osseointegrated device (AOD) for beneficiaries under the age of five (5) with certain types of hearing loss.
System Number: 21608Notice | Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 10/2/2015 Final Date: 10/28/2015
Effective Date: 12/1/2015 Withdrawal Date:
Rule: Title 23: Medicaid, Part 202: Hospital Services, Chapter 1: Inpatient Services, Rule 1.3: Prior Authorization of Inpatient Hospital Services Summary: This filing includes language for the requirement of hospitals to notify the Division of Medicaid within five (5) calendar days of a newborn’s birth via the Newborn Enrollment Form located on the Division of Medicaid’s website.
System Number: 21624Notice | Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 10/1/2015 Final Date: 10/27/2015
Effective Date: 12/1/2015 Withdrawal Date:
Rule: Title 23: Division of Medicaid, Part 207: Institutional Long Term Care, Chapter 3: Intermediate Care Facility for Individuals with Intellectual Disabilities (ICF/IID), Rule 3.2: Provider Enrollment/Provider Agreement Summary: This filing removes time-limited provider agreement language for an Intermediate Care Facility for Individuals with Intellectual Disabilities (ICF/IID) and includes language for hearings and appeals when an ICF/IID no longer meets the applicable Conditions of Participation as determined by Mississippi State Department of Health (MSDH) and Centers for Medicare and Medicaid Services(CMS).
System Number: 21616Notice | Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 9/29/2015 Final Date: 10/26/2015
Effective Date: 12/1/2015 Withdrawal Date:
Rule: Title 23: Division of Medicaid, Part 202: Hospital Services, Chapter 2: Outpatient Services, Rule 2.11: Diabetes Self-Management Training (DSMT) Summary: This filing relocates Rule 2.11: Diabetes Self-Management Training (DSMT) from Title 23: Medicaid, Part 202: Hospital Services to New Rule 5.6 in Title 23: Medicaid, Part 200: General Provider Information and removes language which limits DSMT coverage to the outpatient hospital setting to any provider who is a current Mississippi Medicaid provider, located in the State of Mississippi, and accredited by the American Diabetes Association (ADA) or the American Association of Diabetes Educators (AADE).
System Number: 21606Notice | Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 9/29/2015 Final Date: 10/26/2015
Effective Date: 12/1/2015 Withdrawal Date:
Rule: Title 23: Medicaid, Part 200: General Provider Information, Chapter 5: General, New Rule 5.6: Diabetes Self-Management Training (DSMT) Summary: This filing relocates Rule 2.11: Diabetes Self-Management Training (DSMT) from Title 23: Medicaid, Part 202: Hospital Services to New Rule 5.6 in Title 23: Medicaid, Part 200: General Provider Information and removes language which limits DSMT coverage to the outpatient hospital setting to any provider who is a current Mississippi Medicaid provider, located in the State of Mississippi, and accredited by the American Diabetes Association (ADA) or the American Association of Diabetes Educators (AADE). Non-substantive change to rule 5.6.G. which adds a description to the acronym EPSDT.
System Number: 21607Notice | Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 5/6/2015 Final Date: 6/1/2015
Effective Date: 7/1/2015 Withdrawal Date:
Rule: Title 23: Medicaid, New Part 225: Telemedicine, New Chapter 1: Telehealth, New Rules 1.1-1.6, New Chapter 2: Remote Patient Monitoring, New Rules 2.1-2.6, New Chapter 3: Teleradiology, New Rules 3.1-3.6, New Chapter 4: Continuous Glucose Monitoring Services, New Rules 4.1-4.6.
Summary: This filing is to add New Part 225: Telemedicine which includes coverage language for telehealth, remote patient monitoring, teleradiology and continuous glucose monitoring services. Although Chapter 3: Teleradiology is a New Chapter, the language is struck from Part 220: Radiology and moved to the New Chapter 3 with revisions. Per Miss. Code Ann. § 25-43-3.109, the proposed filing has been revised to include the definition of telemedicine, clarification for the reimbursement of the telehealth originating site facility fee and removed the certification requirement for a telepresenter.
System Number: 21320Notice | Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 4/23/2015 Final Date: 5/19/2015
Effective Date: 7/1/2015 Withdrawal Date:
Rule: Title 23: Division of Medicaid, Part 100: General Provisions, Chapter 9: Administrative Rules, New Rules 9.1: Public Notice, 9.2: Public Records and 9.5: Public Hearings.
Summary: This filing is to include new rules detailing the Division of Medicaid’s compliance with state and federal regulations regarding providing public notice prior to making submissions to the Centers for Medicare and Medicaid Services (CMS), establishing an official written policy regarding requests for public records in accordance with the Public Records Act and outlining the procedures for holding public hearings for the purpose of allowing the public an opportunity to provide input.
System Number: 21292Notice | Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 4/2/2015 Final Date: 4/28/2015
Effective Date: 6/1/2015 Withdrawal Date:
Rule: Title 23: Division of Medicaid, Part 306: Third Party Recovery, Chapter 1: Third Party Recovery, Rule 1.1: General. Non-substantive changes to Rules: 1.2, 1.3, 1.4, 1.5, and 1.6.
Summary: This filing is to clarify the definition of Third Party to mirror the definition in 42 CFR § 433.136. Non-substantive changes to include the appropriate CFR citations in the sources have also been included.
System Number: 21226Notice | Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 4/2/2015 Final Date: 4/28/2015
Effective Date: 6/1/2015 Withdrawal Date:
Rule: Title 23: Medicaid, Part 200: General Provider Information, Chapter 3: Beneficiary Information, Rule 3.4: Eligibility for Medicare and Medicaid
Summary: This filing is to include, for purposes of reimbursement, co-payments charged by a Medicare Part C plan are considered to be coinsurance as instructed by the Center for Medicare and Medicaid Services (CMS) guidance regarding compliance with 42 U.S.C. § 1396a.
System Number: 21225Notice | Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 8/4/2014 Final Date: 8/29/2014
Effective Date: 10/1/2014 Withdrawal Date:
Rule: Title 23: Division of Medicaid, Part 305: Program Integrity, Chapter 1: Program Integrity, Rule 1.1: Fraud and Abuse
Summary: The MS Division of Medicaid’s Administrative Code final filing is to amend Title 23: Medicaid, Part 305: Program Integrity, Chapter 1: Program Integrity, Rule 1.1: Fraud and Abuse to include current language to require all provider demand letters for repayment of overpayment be sent via certified mail which will allow the Division of Medicaid to document the date of receipt of the demand letter and uphold the thirty (30) day response time.
System Number: 20742Notice | Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 8/4/2014 Final Date: 8/29/2014
Effective Date: 10/1/2014 Withdrawal Date:
Rule: Title 23: Division of Medicaid, Part 203: Physician Services, New Chapter 10: Implantable Medical Devices, New Rule 10.1: Skin and Soft Tissue Substitutes
Summary: The MS Division of Medicaid’s Administrative Code final filing is to add New Chapter 10: Implantable Medical Devices and New Rule 10.1: Skin and Soft Tissue Substitutes to Title 23: Medicaid, Part 203: Physician Services to include coverage language and criteria for the use skin and soft tissue substitutes.
System Number: 20741Notice | Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 7/10/2014 Final Date: 8/7/2014
Effective Date: 10/1/2014 Withdrawal Date:
Rule: Title 23: Division of Medicaid; Part 200: General Provider Information, Chapter 2: Benefits, Rule 2.2: Non-Covered Services
Summary: This filing is to add language to include procedures, products and services for conditions and indications that are non-covered services and to include language for Home and Community Based Services (HCBS) waivers non-covered services.
System Number: 20696Notice | Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 7/2/2014 Final Date: 7/29/2014
Effective Date: Withdrawal Date:
Rule: Title 23: Medicaid, Part 300: Appeals, Chapter 1: Appeals, New Rule 1.5: Review for Medical Necessity and/or Independent Verification and Validation (IV&V).
Summary: The MS Division of Medicaid’s Administrative Code proposed filing is to add a new rule to Title 23: Medicaid, Part 300: Appeals, Chapter 1: Appeals, New Rule 1.5: Review for Medical Necessity and/or Independent Verification and Validation (IV&V). This filing is to include the appeal rights for providers who are dissatisfied with final administrative decisions of the Division of Medicaid relating to disallowances as a result of a review for medical necessity or Independent Verification and Validation (IV&V) decision described in Miss. Admin. Code Part 202, Rule 1.18.A.
System Number: 20670Notice | Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 6/26/2014 Final Date: 7/22/2014
Effective Date: 9/1/2014 Withdrawal Date:
Rule: Title 23: Division of Medicaid; Part 103: Resources, Chapter 4: Countable Resources; New Rules 4.21 and 4.22
Summary: The MS Division of Medicaid’s Administrative Code proposed filing is to amend Title 23: Medicaid, Part 103: Resources, Chapter 4: Countable Resources, New Rule 4.21 and New Rule 4.22. This filing addresses the countablity of entrance fees to continuing care retirement communities and the exclusion of long term care coverage for individuals with substantial home equity. These rules are new to the Administrative Code but have been Medicaid policy since 2008. The effective date of this filing will revert back to the effective date of SPA 2008-003, July 1, 2014.
System Number: 20661Notice | Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 6/25/2014 Final Date: 9/30/2014
Effective Date: 9/30/2014 Withdrawal Date: 9/30/2014
Rule: Title 23: Medicaid, Part 203: Physician Services, Chapter 1: General, New Rule 1.11: Global Packaging WITHDRAWN (Administrative Bulletin Number 20743)
Summary: The MS Division of Medicaid’s Administrative Code final filing is to establish policies for Global Package coverage. Global Package is an edit that allows for lump sum payment which includes all necessary services normally furnished by the “same physician” before, during and after a procedure and all evaluation and management (E&M) visits related to a procedure based on an assigned post-op period by Centers of Medicare and Medicaid Services (CMS). WITHDRAWN (Administrative Bulletin System Number 20743)
System Number: 20802Notice
Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 6/25/2014 Final Date: 7/21/2014
Effective Date: 9/1/2014 Withdrawal Date:
Rule: Title 23: Medicaid, Part 102: Non-Financial Requirements, Chapter 3: Aliens, Rule 3.9
Summary: The MS Division of Medicaid’s (DOM) Administrative Code proposed filing is to amend Title 23: Medicaid, Part 102: Non-Financial Requirements, Chapter 3: Aliens, Rule 3.9: Requirement for Forty (40) Qualifying Quarters. Rule 3.9.D. removes the requirement for certain classes of aliens to have forty (40) qualifying quarters (QQ) of work coverage under the Social Security Act (SSA). This is a change required by the Centers for Medicare and Medicaid Services (CMS) for the Affordable Care Act (ACA)-related State Plan Amendment (SPA) for Citizenship & Immigration Status (S89), approved as 13-0023-MM6 with an effective date of January 1, 2014.
System Number: 20656Notice | Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 6/25/2014 Final Date: 8/29/2014
Effective Date: 10/1/2014 Withdrawal Date:
Rule: Title 23: Medicaid, Part 203: Physician Services, Chapter 1: General, New Rule 1.11: Global Packaging
Summary: The MS Division of Medicaid’s Administrative Code final filing is to establish policies for Global Package coverage. Global Package is an edit that allows for lump sum payment which includes all necessary services normally furnished by the “same physician” before, during and after a procedure and all evaluation and management (E&M) visits related to a procedure based on an assigned post-op period by Centers of Medicare and Medicaid Services (CMS).
System Number: 20743Notice | Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 5/1/2014 Final Date: 5/27/2014
Effective Date: 7/1/2014 Withdrawal Date:
Rule: Title 23: Medicaid, Part 214: Pharmacy Services, Chapter 1: General Pharmacy, Rule1.3: Drugs Subject to Exclusion or Otherwise Restricted.
Summary: Effective January 1, 2014, section 2502 of the Affordable Care Act (ACA) amends section 1927(d)(2) of the Social Security Act by removing barbiturates, benzodiazepines and all drugs used for smoking cessation from the list of drugs a state Medicaid program may exclude from the coverage or otherwise restrict. This filing removes barbiturates and benzodiazepines from the list of excluded or otherwise restricted drugs in Miss. Admin. Code Part 214, Chapter 1, Rule 1.3.
System Number: 20555Notice | Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 3/20/2014 Final Date: 4/21/2014
Effective Date: 6/1/2014 Withdrawal Date:
Rule: Part 208: Home and Community Based Services (HCBS) Long Term Care Chapter 6: Bridge to Independence, Rules 6.1-6.5
Summary: The MS Division of Medicaid’s Administrative Code filing is to propose new rules Title 23 Medicaid, Part 208 Home and Community Based Services (HCBS) Long Term Care, Chapter 6: Bridge to Independence Rules 6.1 – 6.5 as a covered service when certain criteria are met.
System Number: 20460Notice | Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 2/28/2014 Final Date: 3/25/2014
Effective Date: 5/1/2014 Withdrawal Date:
Rule: Part 208: Home and Community Based Services (HCBS) Long Term Care, Chapter 3: HCBS Assisted Living Waiver, Rules 3.1-3.11, New rules 3.12-3.14
Summary: This MS Division of Medicaid’s Administrative Code filing is to modify Title 23, Part 208, Chapter 3: Assisted Living Waiver to reflect changes in the renewal of the Assisted Living Waiver by the Centers of Medicare and Medicaid (CMS) effective October 1, 2013.
System Number: 20409Notice | Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 9/25/2013 Final Date: 10/31/2013
Effective Date: 12/1/2013 Withdrawal Date:
Rule: Admin Code Title 23 Medicaid, Part 206: Mental Health Services, Chapter 2: MYPAC, Rules 2.1-2.10, and New Rule 2.11.
Summary: The MS Division of Medicaid’s Administrative Code filing is to amend Title 23, Part 206: Mental Health Services, Chapter 2: MYPAC to reflect the approval of State Plan Amendment (SPA) 2012-003 Rehabilitation Option. Mississippi Youth Programs Around the Clock (MYPAC), a five year demonstration grant, ended enrollment of new beneficiaries on September 30, 2012. The Division of Medicaid submitted SPA 2012-003 Rehabilitation Option with an effective date of July 1, 2012, to continue MYPAC services after the end of the demonstration grant. To avoid duplication of services, MYPAC services under the State Plan are effective November 1, 2012, to coincide with the operational start date.
System Number: 20122Notice | Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 7/31/2013 Final Date: 8/26/2013
Effective Date: 10/1/2013 Withdrawal Date:
Rule: Title 23: Division of Medicaid, Part 202: Hospital Services, Chapter 1: Inpatient Services, Rules: 1.4B.1-6, New Rules: 5.1-5.1
Summary: (1) Moved Rule: 1.4.B.1- 6 to a new Chapter 5: Hospital Procedures, with new Rules: 5.1-5.6 because listed procedures are not limited to the inpatient hospital setting. (2) The language “in an inpatient or outpatient hospital setting in accordance with current standards of medical practice” was added to Rules 5.1-5.4 and 5.6. The language “in an outpatient hospital setting in accordance with current standards of medical practice” was added to Rule 5.5; (3) Rule: 1.8: Sterilization was moved to Rule: 5.3, Hysterectomy was removed from the Rule title and clarified existing language to 5.3.A.4, B.3, C.1, C.2, C.3; (3) Added new Rule 5.6: Hysterectomy. (4) “Revised 10/01/2012” removed from Rules: 5.3 and 5.4 due to non-substantive grammatical change.
System Number: 19999Notice | Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 6/17/2013 Final Date: 7/15/2013
Effective Date: 8/14/2013 Withdrawal Date:
Rule: Part 305 Program Integrity, Chapter 1, Rule 1.1: Fraud and Abuse
Summary: This Administrative Code filing is to make a correction to Title 23: Part 305: Program Integrity, Chapter 1, Rule 1.1: Fraud and Abuse to correspond with Medicaid’s Medical Assistance Participation Agreement signed by providers.
System Number: 19885Notice | Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 6/12/2013 Final Date: 7/12/2013
Effective Date: 7/1/2013 Withdrawal Date:
Rule: Part 220, Radiology Chapter 1 General Rule 1.7 – Prior Authorization
Summary: This Administrative Code filing is to modify Title 23, Part 220 Radiology, Chapter 1 General, Rule 1.2 and add new Rules 1.7-1.10 to require prior authorization for certain outpatient advanced imaging procedures by the Division of Medicaid’s Utilization Management/Quality Improvement Organization (UM/QIO) except when performed during an inpatient hospitalization, during an emergency room visit or during a twenty-three (23) hour observation period. According to the SOS APA 25-43-1.103, the effective date is July 1, 2013 to correspond with the approved SPA 2013-007.
System Number: 19884Notice | Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 11/1/2012 Final Date: 11/29/2012
Effective Date: 1/1/2013 Withdrawal Date:
Rule: Administrative Code Title 23: Medicaid Part 208 Home and Community Based Services , Long Term Care , Chapter 1: HCBS Elderly and Disabled Waiver
Summary: The MS Division of Medicaid’s Administrative Code filing is to modify Title 23, Part 208, Chapter 1: Home and Community Based Service (HCBS) Elderly and Disabled Waiver (ILW) to clearly reflect changes in the approved Independent Living Waiver approved by The Centers of Medicare and Medicaid effective July 1, 2012.
System Number: 19250Notice | Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 11/1/2012 Final Date: 11/29/2012
Effective Date: 1/1/2013 Withdrawal Date:
Rule: Administrative Code Title 23: Division of Medicaid Part 208 Home and Community Based Services, Long Term Care, Chapter 2: HCBS Independent Living Waiver
Summary: The MS Division of Medicaid’s Administrative Code filing is to modify Title 23, Part 208, Chapter 2: Home and Community Based Service (HCBS) Independent Living Waiver (ILW) to clearly reflect changes in the approved Independent Living Waiver approved by The Centers of Medicare and Medicaid effective July 1, 2012.
System Number: 19249Notice | Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 9/14/2012 Final Date: 10/15/2012
Effective Date: 11/14/2012 Withdrawal Date:
Rule: Administrative Code Title 23: Medicaid, Part 103 Resources, Chapter 7 OBRA-93 and DRA Transfer Policy, Rule 7.1 OBRA-93 and DRA Transfer Policy Principles.
Summary: This is a technical correction to reflect the source used to arrive at average private pay nursing facility rates and to add an exemption for non-home transfers that was inadvertently omitted.
System Number: 19168Notice | Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 5/7/2012 Final Date: 6/1/2012
Effective Date: 7/1/2012 Withdrawal Date:
Rule: Title 23 Part 214 Pharmacy Chapter 1 Rule 1.10 Preferred Drug List
Summary: This Rule was inadvertently not filed with the April 1, 2012, Division of Medicaid’s Compilation filing required by APA Rule 3.2. Additionally, Rule 1.10 was amended with A.4 deleted due to not applicable to PDL which is also addressed under Rule 1.8. The language for B. was changed due to the Pharmacy Benefit Manager no longer existing. The CMS requirement for 24-hour PA review was added on E.
System Number: 18815Notice | Full Text